Pompo

Is marijuana good medicine?
Proposal to legalize it for patients finds strong support and strong fears
10/25/08|Detroit Free Press| by Megha Satyanarayana • Free Press Staff Writer



For many voters, the decision to back or reject a proposal to give people with severe and terminal illnesses legal access to marijuana will come down to their thoughts on compassion for sick and dying people versus those on preventing drug abuse.

It's a debate that has divided the medical community, with each side pledging it is concerned with protecting Michiganders' health.

Supporters have campaigned for months, saying medical marijuana is the only thing that gives relief to some patients, mitigating the worst side effects of the best medical treatments. And the measure -- Proposal 1 -- has strong early support, boasting a 66%-25% lead in the most recent Detroit Free Press-Local 4 Michigan Poll.

But an opposition group of law enforcement, business and medical community members has campaigned hard in recent weeks against Proposal 1. It warns of a dystopia of strip-mall pot shops, teens with easy access to a so-called gateway drug, and crimes unpunished because of a medical marijuana defense.

There are many unanswered questions in the text of the proposal. It's not clear where users would buy seeds to grow their plants, and crime statistics are mixed in the 12 states with legalized medical marijuana. And, as federal law would still supersede state law, could agents rain down on Michigan as they have in California, busting pot shops?

One patient's relief
For the family of Caprice Wagner of Birmingham, who died in July at 24 after a four-month battle with T-cell lymphoma, there is no question about the drug's benefits. The Vicodin she was prescribed barely touched the hallucination-causing pain -- so intense that her nurse described it to Wagner's mother, Robin O'Grady, as "like a Mack truck hit you."

But Wagner found relief when she started using marijuana for the pain on the advice of a medical professional.

"It helped suppress the nausea, eased the cramps, helped her sleep. It was good to see her relax, having a little bit of her life force back," said O'Grady, who is fighting for Proposal 1.

The proposal would give patients with pain, nausea and wasting -- common with HIV/AIDS, cancer and neurodegenerative diseases -- prosecution-free access to smoked or ingested marijuana, per a doctor's letter of recommendation. Users and their caregivers would have to carry a state identification card, registered through the Department of Community Health.

They could grow their own supply of 12 plants and could carry 2.5 ounces at a time. It still would be illegal to use marijuana in a public place or operate a car under the influence.

By law, the Department of Community Health would administer the program and report to the Legislature. It is preparing its guidelines in case the measure becomes law.

While the department takes no stand on the proposal, Donald Allen, director of the Office of Drug Control and Policy, said, "These people certainly deserve our empathy, but ... it's not in the public health interest to see people smoke. Period."

The Michigan Medical Association agrees, said Dr. Dan Michael, a member of the MMA House of Delegates and Citizens Protecting Michigan's Kids, the leading opponents of the measure.

There is no way to deliver measured doses, and the association cannot promote smoking of any sort. He also said there isn't enough evidence for efficacy, making medical marijuana "bad medicine."

Nurses say otherwise. Joyce Stein of the Michigan Nurses Association's Congress on Public Policy, said nurses on the front line of end-of-life and cancer care see what medical marijuana can do.

"Doctors are looking for cures, and nurses are looking for comfort in pain," she said. "This is one more comfort measure they can offer."

Proponents have money edge
Medical marijuana was once legal in Michigan. But the program created under a 1979 law was dependent on the federal government and a reluctant state health department, said Stephen V. Monsma, the state legislator who authored the bill. It came up for review in the 1980s and wasn't renewed.

Proposal 1 is sponsored by the Marijuana Policy Project, a Washington-based group, through the Michigan Coalition for Compassionate Care, made up of patients, medical personnel and marijuana law reform proponents. And campaign finance documents filed Friday showed it with a significant fund-raising edge, reporting the group raised more than $1.5 million and spent nearly $1.3 million

By comparison, Citizens Protecting Michigan's Kids reported raising $125,500 and spending a little more than $96,000.

The proposal smacks of the "law of unintended consequences," said William Schuette, a Michigan Court of Appeals judge and a leader of Citizens Protecting Michigan's Kids. He points to issues in California, including reports of increased crime and federal crackdowns on pot shops. Not explicitly outlawing pot shops implicitly allows them, he said.

"We're sensitive to the problems associated with pain management," he said, "but this is not a Michigan proposal."

He points to studies from the Substance Abuse and Mental Health Services Administration, showing increases in marijuana use in states with medical marijuana laws as evidence it would be more available to teens.

Diane Byrum, spokeswoman for Proposal 1, disputes that, saying a study by the Marijuana Policy Project and the State University of New York, Albany, shows teens in states with the laws are using pot less. The Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System survey shows mixed results for the states with medical marijuana laws that participated.

Byrum noted that the Michigan proposal wouldn't permit the type of cooperative growing that allows pot shops to exist in California. Those kinds of operations are what have faced federal crackdowns.

Loophole concerns
Ferndale is among a handful of Michigan communities with largely symbolic ordinances allowing medical marijuana, although police Capt. Timothy Collins said it is not enforced because those users are still subject to prohibitive state and federal laws.

Collins said that marijuana is not a big issue in Ferndale schools. But he has problems with the state proposal, which he said doesn't have enough controls and is poorly written.

"If you look at the legislation, it allows people to grow it in their house for legal use. Bad guys are going to figure out how to skirt the law," he said.

There are loopholes, said Sheila Maxwell, a Michigan State University assistant professor of criminal justice. It's hard to regulate something you can't dose or study the side effects of, she said. Enforcing the section on growing plants in locked rooms would be extra work for law enforcement, she said. As with the 1979 law, she said this proposal should have suggested a temporary law, to best study the effects.

Lance Gable, a Wayne State University associate professor of law and a health law specialist, said the proposal is narrow. Pot shops are a nonissue, since a caregiver can have only five patients in his or her care.

"That would alleviate some of the concerns about creating an infrastructure for marijuana sales," he said.

And where the drugs would come from is the major question about Proposal 1. O'Grady, the woman whose daughter died of T-cell lymphoma, is lending her support to help lift the stigma of criminality, so people who need access to the drug can have it.

Many proponents stay mum on whether patients would have to break the law to buy the seeds. Getting seeds wasn't outlined in other states' proposals, said Bruce Merkin, spokesman for the Marijuana Policy Project.

Deb Brink of Kentwood was a 19-year-old leukemia patient struggling through chemotherapy and a bone marrow transplant in 1978 when she started using medical marijuana. She said people in her hometown would save pot for her when supplies went dry.

Now a four-time cancer survivor and registered nurse fighting for Proposal 1, she still remembers how smoking the drug and drinking tea brewed from its leaves was the only relief from the vomiting that came from her chemo.

"It was four hours of sick, eight hours of relief, and then I would start over," Brink said.

Buzzby

Wouldn't it be just the opposite? By not explicitly allowing pot shops, they'd fall under the "sales of marijuana" laws and be illegal. Caregivers my supply only five patients each. They are to be compensated only for their time and expenses, which would seem to exclude the possibility of $400/oz weed (like they have at CA pot shops).

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SpiralArchitect

This made me smile. For once we out-sourced them. And it shows. It's very likely this initiative will pass, and for all the good reasons too.

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dsides

I live in Michigan and I've only seen MPP ads. This is definitely a good thing.